Simulation is an educational approach that promotes the mastery of technical skills while advancing the development of non-technical competencies, both of which are widely acknowledged as essential in clinical practice. This review aimed to synthesize findings on the impact of simulation in enhancing critical thinking and reflection among nursing and medical students. Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a systematic review was conducted by searching the following databases: PubMed, Science Direct, and Scopus. The quality of the included studies was assessed using Joanna Briggs Institute critical appraisal tools. The protocol was previously registered in the PROSPERO registry (CRD42022371971). From 1,323 studies identified in primary research, 16 were included in this review, involving a total of 1,283 students. Of the 16 studies, seven investigated the impact of simulation on critical thinking and reported a positive effect compared to traditional teaching methods. For student reflection, only one study addressed this theme and reported a positive effect on nursing students. This review demonstrated that simulation has a positive impact on critical thinking; however, its impact on reflection remains inconclusive. Further research is essential to explore its effects across diverse populations, including those in developing countries, to maximize its educational potential in health professions education.

A lack of standardized communication was identified among Intesive Care Unite (ICU) providers in a public hospital in southern Morocco. This quasi-experimental pre-post test study aimed to evaluate the effectiveness of personalized simulation-based learning using the SAED tool (French adaptation of SBAR) to enhance structured communication between nurses and physicians in intensive care. Eleven nurses participated in the study, which employed three data collection instruments: a sociodemographic questionnaire, a SAED knowledge assessment, and an evaluation of communication as perceived by the recipient. Data analysis through SPSS revealed significant improvements in participants' theoretical knowledge of the SAED tool and their performance in structured communication during telephone calls with physicians. The study demonstrates the effectiveness of this approach in enhancing ICU nurses' communication skills, suggesting potential benefits for patient safety and quality of care, although further research with larger samples is recommended to validate these findings.

Background: This study evaluated the impact of high-fidelity simulation versus simulation with standardized patients on the development of reflective practice among medical students. Methods: A randomized controlled trial design with both pre- and post-simulation assessments was adopted. Thirty-two final-year medical students were randomly assigned to two groups (Group 1: high-fidelity simulation (n = 16); Group 2: simulation with standardized patients (n = 16)). Each group participated in six sessions over the course of two months, including six identical scenarios for both groups. The Groningen Reflection Ability Scale (GRAS) was used to assess the participants’ reflection skills before and after the simulation. Data were analyzed using descriptive statistics, paired t-tests for within-group changes, and independent t-tests for between-group comparisons. Results: Reflection scores improved significantly from pre- to post-simulation across the combined sample (p < 0.05). Within-group analyses demonstrated statistically significant improvements in self-reflection (31.3 ± 7.11 vs. 36.8 ± 5.34; p < 0.001), empathic reflection (19.1 ± 4.68 vs. 20.6 ± 4.51; p = 0.020), and reflective communication (23.1 ± 5.11 vs. 25.5 ± 4.35; p < 0.001). Additionally, between-group comparison revealed that the high-fidelity simulation group attained a significantly higher total reflection ability score compared with the standardized patient group (91.8 ± 7.70 vs. 74.0 ± 11.55; p <0.001). Conclusions: Simulation practice, whether high-fidelity or with standardized patients, helps to improve students’ reflection. However, high-fidelity simulation was proven to be more effective than simulation with standardized patients. This study reinforces the use of simulation as a tool for developing reflective practice skills in medical training.

Background & Objective. Peer learning is increasingly recognized as a central strategy in competency-based nursing education, enhancing knowledge construction, clinical reasoning, communication skills, and learner autonomy. In Morocco, however, its use remains limited by traditional teaching approaches and structural constraints. This study aimed to explore the factors that influence peer learning ...

Background: Anesthesia ventilator preparation is essential for ensuring patient safety.The “Room ofError” (ROE) is a low-fidelity simulation method designed to improve patient safety skills. This study aimed to evaluate the effectivenessof in-situ ROE simulation training in improving student nurse anesthetists’ clinical performance in anesthesia ventilator preparation and to compare its impact with that of didactic lectures. Methods: A quasi-experimental pilot study was conducted in a public hospital in Morocco.Thirty-nine nurse anesthesia students were randomly assigned to two groups: an experimental group (n = 20) that received in situ ROE simulation training and a control group (n = 19) that received only lecture-based instruction. Performance was assessed using an author-developed scale. Within- and between-group comparisons were performed using McNemar’s and Fisher’s exact tests (p < 0.05). Results: TheROE simulation significantly improved the participants’ performance in anesthesia ventilator preparation (p< 0.05).The experimental groupdemonstrated statistically significant differencesin onlythree anesthesia ventilator preparationprocedures: oxygen reserve checks (p< 0.001), anti-pollution system verification (p< 0.001), and suction device testing (p = 0.04). Conclusion: Students’ performance improved after the simulation, indicating effective transfer of learning to the clinical setting.Compared to didactic lectures, the ROE method was more effective in developing critical technical skills related to anesthesia ventilator preparation.

Purpose: This review examined the impact of learner role—active participant versus observer—on learning outcomes in healthcare simulation-based education using Kirkpatrick’s evaluation model.Methods: Five databases—PubMed, Scopus, Web of Science, ScienceDirect, and EBSCOhost—were searched for studies published from January 2018 to November 2024. Eligibility criteria, defined using the PICOS framework, targeted studies comparing learning outcomes between active participant and observer roles among health professions students and practitioners. Methodological quality was appraised using the Medical Education Research Study Quality Instrument, and findings were synthesized narratively. This review was registered in PROSPERO under registration number CRD42024611988.Results: Of 648 records, 15 studies involving 1,799 participants met the inclusion criteria; role allocation was specifically reported for 644 active participants and 709 observers. Most studies were conducted in high-income countries (13/15) and nursing programs (11/15). At Kirkpatrick Level 1, most studies reported no statistically significant between-role differences, although an active participant advantage emerged for emotional arousal. At Level 2, knowledge, skills, and most attitudinal outcomes did not differ significantly between roles; active participant advantages were observed for technical skills at delayed follow-up, affective competencies in palliative care, and perceived learning transfer. No study assessed Levels 3 or 4.Conclusion: Most studies found no significant differences between observer and active participant roles at Kirkpatrick Levels 1 and 2. Generalizability across all health professions and settings is limited. Pedagogically appropriate use of the observer role supports learning outcomes and may expand access to simulation-based education.